Flash glucose monitoring system: impact on glycemic control and body mass index in type 1 diabetes mellitus

Individual contributions: J. Marques-Sá and M. J. Santos contributed to study conception and design, analysis and interpretation of data. J. Marques-Sá, S. Campos-Lopes, M. Barbosa and I. Ferreira Barros contributed to data colletion. J. Marques-Sá drafted the article. All authors reviewed critically the article and approved the final version.

Disclosure: no potential conflict of interest relevant to this article was reported.

Sex
	Male	94 (52.5%)
	Female	85 (47.5%)
Age (years) ^a a Median (P25, P50) (min; max).		43 (31; 52) (18;80)
Age (groups)
	≤29	40 (22.4%)
	30-39	33 (18.4%)
	40-49	52 (29.1%)
	≥50	54 (30.2%)
Diabetes duration (years) ^a a Median (P25, P50) (min; max).		18 (10; 28) (1; 62)
Diabetes duration (groups) (years)
	≤9	41 (22.9%)
	10-19	55 (30.7%)
	20-29	41 (22.9%)
	≥ 30	42 (23.5%)
Treatment with functional insulin therapy		60 (33.5%)
Long-acting insulin
	Glargine	153 (85.5%)
	Detemir	21 (11.7%)
	NPH	5 (2.8%)
Long-acting insulin daily dose (U) ^a a Median (P25, P50) (min; max).		22 (16; 30) (6; 68)
Long-acting insulin daily dose (U/kg/day) ^a a Median (P25, P50) (min; max).		0.32 (0.26; 0.45) (0.11; 0.90)
HbA₁c (%) ^a a Median (P25, P50) (min; max).		7.9 (7.2; 8.8) (5.6; 13.8)
HbA₁c (groups) (%)
	<7.0	26 (16.2%)
7.0-7.9	56 (34.8%)
	8.0-8.9	42 (26.1%)
	≥9.0	37 (23.0%)
Weight (kg) ^a a Median (P25, P50) (min; max).		67.3 (59.3; 74.5) (48.4; 97.8)
BMI (kg/m²) ^a a Median (P25, P50) (min; max).		24 (21.9; 26.2) (17.2; 33.7)
BMI (Groups) (kg/m²)
	<25.0	97 (61.1%)
	25.0-29.9	54 (34.0%)
	≥30.0	8 (5.0%)
FGM usage time (months)
	6-11	46 (25.7%)
	12-17	62 (34.6%)
	18-23	54 (30.2%)
	≥24	17 (9.5%)

HbA₁c		Initial	6 months	12 months	HR	CI	p
Global		7,9 (7,2; 8,8) (5,6; 13,8)	7,6 (7,0; 8,3) (5,7; 16,4)	7,7 (6,95; 8,5) (5,9; 13,7)	-0.127	-0.237; -0.016	<0.05
Sex
	Male	7,7 (7,1; 8,6) ^* * p < 0.05.	7,6 (6,9; 8,2)	7,5 (6,9; 8,4)	0.0136	-0.201; 0.228	0.901
	Female	8,3 (7,4; 9,3) ^* * p < 0.05.	7,6 (7,2; 8,6)	7,8 (7,2; 8,6)	0.0136	-0.201; 0.228	0.901
Treatment with functional insulin therapy
	No	7,9 (7,3; 9,3)	7,6 (7,1; 8,3)	7,8 (7,2; 8,5)	-0.022	-0.241; 0.197	0.844
	Yes	7,9 (7,1; 8,7)	7,5 (7,0; 8,1)	7,6 (6,8; 8,5)	-0.022	-0.241; 0.197	0.844
Age (groups)
	≤29 years	8,0 (7,2; 9,3)	7,4 (7,0; 8,5)	7,6 (6,8; 8,5)	-0.018	-0.113; 0.077	0.710
	30 – 39 years	8,2 (7,2; 9,3)	7,6 (7,0; 8,6)	7,6 (7,2; 8,5)
	40 – 49 years	8, 0 (7,4; 8,7)	7,7 (6,95; 8,3)	7,8 (6,9; 8,6)
	≥50 years	7,6 (7,1; 8,6)	7,6 (7,3; 7,9)	7,9 (7,4; 8,4)
Diabetes duration (groups)
	≤9 years	8,0 (7,3; 9,5)	7,8 (7,2; 8,8)	7,6 (7,2; 8,5)	-0.094	-0.187; -0.001	p < 0.05^a
	10-19 years	8,0 (7,5; 8,8)	7,8 (7,3; 8,3)	7,7 (7,2; 8,3)
	20-29 years	8,2 (7,2; 9,0)	7,6 (6,8; 8,2)	8,2 (6,8; 8,7)
	≥30 years	7,6 (6,9; 8,2)	7,5 (6,8; 7,9)	7,5 (6,7; 7,9)
BMI (groups)
	<25.0 kg/m²	8,1 (7,5; 9,3)	7,9 (7,3; 8,5) ^* * p < 0.05.	7,9 (7,3; 8,6) ^ 0.05 < p < 0.1.	-0.014	-0.177; 0.204	0.889
	25.0-29.9 kg/m²	7,7 (7,2; 8,6)	7,5 (6,8; 7,8) ^* * p < 0.05.	7,4 (6,9; 7,9) ^ 0.05 < p < 0.1.
	≥30.0 kg/m²	8,1 (7,4; 9,5)	8,2 (7,9; 9,7) ^* * p < 0.05.	8,8 (7,6; 9,0) ^ 0.05 < p < 0.1.
Initial HbA₁c (groups)
	<7%	6,5 (6,2; 6,7) ^* * p < 0.05.	6,5 (6,1; 7,1) ^* * p < 0.05.	6,5 (6,2; 6,9) ^* * p < 0.05.	1.012	0.889; 1.144	<0.001^b
	7-7.9%	7,5 (7,2; 7,7) ^* * p < 0.05.	7,4 (7,0; 7,8) ^* * p < 0.05.	7,5 (6,9; 7,9) ^* * p < 0.05.
	8-8,9%	8,4 (8,2; 8,8) ^* * p < 0.05.	8,0 (7,6; 8,5) ^* * p < 0.05.	7,9 (7,5; 8,6) ^* * p < 0.05.
	≥9%	10,2 (9,5; 11,1) ^* * p < 0.05.	9,0 (8,2; 9,7) ^* * p < 0.05.	8,5 (7,7; 10,6) ^* * p < 0.05.

Factor		Coefficient	CI	p
HbA1c evolution 0-6 months		-0.475	-0.762; -0.187	0.001
HbA1c evolution 6-12 months		-0.337	-0.629; -0.045	0.024
Initial HbA1c (%) ^a a Relative to initial HbA1c group < 7.0%.
	7.0-7.9	1.124	0.578; 1.670	<0.001
	8.0-8.9	1.886	1.321; 2.450	<0.001
	≥9.0	3.108	2.454; 3.761	<0.001
Sex		0.042	-0.353; 0.437	0.836
Treatment with functional insulin therapy		-0.162	-0.543; 0.269	0.462
Age (years)		-0.012	-0.030: 0.005	0.171
Diabetes duration (years)		-0.005	-0.026; 0.015	0.612
Initial BMI (kg/m²) ^b b Relative to initial BMI < 25 kg/m2.
	25-29.9	-0.397	-0.793; -0.001	0.049
	≥30.0	-0.657	-1.850; 0.536	0.281
BMI variation 0-6 months		-0.374	-0.598; -0.149	0.001
BMI variation 6-12 months		-0.087	-0.350; 0.176	0.517
Dose variation of long-acting insulin 0-6 months(U/kg/d)		2.098	-1.102; 5.298	0.199
Dose variation of long-acting insulin 6-12 months (U/kg/d)		-3.749	-8.312; 0.815	0.107

BMI		Initial	6 months	12 months	HR	CI
Global		24,0 (21,9; 26,2) (17,2; 33,7)	23,8 (21,9; 26,2) (16,5; 33,3)	24,0 (22,0; 26,2) (17,1; 33,1)	0.124	0.0245; 0.223	<0.05
Sex
	Male	24,0 (22,1; 25,7)	23,7 (21,8; 26,1)	24,3 (22,2; 25,9)	0.0413	-0.163; 0.246	0.692
	Female	24,1 (21,8; 26,7)	23,8 (22,1; 26,6)	23,8 (21,8; 26,9)	0.0413	-0.163; 0.246	0.692
Treatment with functional insulin therapy
	No	24,1 (22,4; 26,4)	23,8 (22,1; 26,6)	24,3 (22,3; 26,5)	-0.032	-0.252; 0.188	0.776
	Yes	23,9 (20,5; 25,9)	23,8 (21,1; 25,8)	23,8 (20,5; 25,7)	-0.032	-0.252; 0.188	0.776
Age (groups)
	≤29 years	23,8 (21,7; 24,5) ^ 0.05 < p < 0.1.	23,6 (21,8; 24,9)	23,2 (21,9; 25,4) ^* * p < 0.05.	-0.0604	-0.156; 0.035	0.213
	30–39 years	22,9 (20,9; 25,4) ^ 0.05 < p < 0.1.	23,6 (21,7; 25,9)	22,2 (21,3; 25,0) ^* * p < 0.05.
	40–49 years	25,2 (22,6; 27,4) ^ 0.05 < p < 0.1.	24,4 (22,3; 27,8)	25,3 (22,5; 28,2) ^* * p < 0.05.
	≥50 years	24,2 (22,6; 26,2) ^ 0.05 < p < 0.1.	23,8 (22,2; 26,0)	25,0 (23,3; 26,3) ^* * p < 0.05.
Diabetes duration (groups)
	≤9 years	23,8 (22,1; 25,4) ^* * p < 0.05.	23,4 (22,1; 25,4) ^ 0.05 < p < 0.1.	23,8 (22,1; 25,5)	-0.012	-0.1097; 0.086	0.814
	10-19 years	23,5 (21,6; 25,4) ^* * p < 0.05.	22,4 (21,7; 25,4) ^ 0.05 < p < 0.1.	22,8 (21,7; 25,8)
	20-29 years	23,9 (22,4; 27,0) ^* * p < 0.05.	24,0 (22,4; 26,6) ^ 0.05 < p < 0.1.	24,9 (21,5; 27,0)
	≥30 years	25,5 (23,2; 27,5) ^* * p < 0.05.	25,0 (23,0; 27,2) ^ 0.05 < p < 0.1.	25,1 (23,6; 27,2)
Initial BMI (groups)
	<25 kg/m²	22,6 (20,9; 23,8) ^* * p < 0.05.	22,6 (21,2; 23,8) ^* * p < 0.05.	22,5 (21,1; 23,9) ^* * p < 0.05.	4.484	3.997; 4.969	<0.05 ^a a Group 25-29.9 kg/m2 and ≥ 30 kg/m2.
	25-29.9 kg/m²	26,4 (25,6; 27,6) ^* * p < 0.05.	27,0 (25,6; 28,4) ^* * p < 0.05.	26,5 (25,3; 28,5) ^* * p < 0.05.
	≥30 kg/m²	31,5 (30,3; 32,7) ^* * p < 0.05.	31,2 (30,6; 31,6) ^* * p < 0.05.	31,4 (31,2; 31,8) ^* * p < 0.05.
Initial HbA1c (groups)
	<7%	24,2 (22,3; 25,2)	23,0 (22,0; 24,9)	23,6 (21,6; 25,1)	0.122	0.0165; 0.227	<0.05 ^b b Group 8-8.9% and ≥ 9%.
	7-7.9%	25,1 (22,1; 27,4)	24,0 (22,0; 28,1)	24,1 (22,4; 27,3)
	8-8,9%	24,0 (21,5; 26,4)	24,2 (22,1; 27,8)	24,6 (23,0; 26,1)
	≥9%	23,9 (21,6; 25,2)	23,4 (21,4; 25,6)	23,5 (22,2; 26,2)

Factor		Coefficient	CI	p
BMI evolution 0-6 months		0.257	0.025; 0.489	0.030
BMI evolution 6-12 months		0.373	0.141; 0.605	0.002
Initial HbA1c (%) ^a a Relative to initial HbA1c group < 7.0%.
	7.0-7.9	1.053	-0.603; 2.709	0.213
	8.0-8.9	0.986	-0.644; 2.616	0.236
	≥9.0	0.988	-1.048; 3.024	0.342
Sex		0.181	-0.987; 1.350	0.761
	Treatment with functional insulin therapy	-0.905	-2.206; 0.397	0.173
	Age (years)	-0.013	-0.062; 0.036	0.598
	Diabetes duration (years)	-0.008	-0.064; 0.049	0.791
Initial BMI (kg/m²) ^b b Relative to initial BMI < 25 kg/m2.
	25-29.9	4.319	3.185; 5.453	0.000
	≥30.0	8.112	3.919; 12.306	0.000
HbA1c variation 0-6 months		-0.365	-0.861; 0.131	0.149
HbA1c variation 6-12 months		0.188	-0.483; 0.859	0.583
Dose variation of long-acting insulin 0-6 months (U/kg/d)		2.578	-5.764; 10.920	0.545
Dose variation of long-acting insulin 6-12 months (U/kg/d)		11.173	-2.964; 25.310	0.121

[1] Correspondence to: Juliana Marques Sá, Sete Fontes, São Victor 4710-243 – Braga, Portugal. juliana.pm.sa@gmail.com

Brasil

Brasil

Flash glucose monitoring system: impact on glycemic control and body mass index in type 1 diabetes mellitus

ABSTRACT

Objective:

Subjects and methods:

Results:

Conclusions: